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BMC Cancer
Published in: BMC Cancer 1/2018

Open Access 01-12-2018 | Research article

A systematic review of the risk factors for clinical response to opioids for all-age patients with cancer-related pain and presentation of the paediatric STOP pain study

Authors: Ersilia Lucenteforte, Laura Vagnoli, Alessandra Pugi, Giada Crescioli, Niccolò Lombardi, Roberto Bonaiuti, Maurizio Aricò, Sabrina Giglio, Andrea Messeri, Alessandro Mugelli, Alfredo Vannacci, Valentina Maggini

Published in: BMC Cancer | Issue 1/2018

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Abstract

Background

Inter-patient variability in response to opioids is well known but a comprehensive definition of its pathophysiological mechanism is still lacking and, more importantly, no studies have focused on children. The STOP Pain project aimed to evaluate the risk factors that contribute to clinical response and adverse drug reactions to opioids by means of a systematic review and a clinical investigation on paediatric oncological patients.

Methods

We conducted a systematic literature search in EMBASE and PubMed up to the 24th of November 2016 following Cochrane Handbook and PRISMA guidelines. Two independent reviewers screened titles and abstracts along with full-text papers; disagreements were resolved by discussion with two other independent reviewers. We used a data extraction form to provide details of the included studies, and conducted quality assessment using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.

Results

Young age, lung or gastrointestinal cancer, neuropathic or breakthrough pain and anxiety or sleep disturbance were associated to a worse response to opioid analgesia. No clear association was identified in literature regarding gender, ethnicity, weight, presence of metastases, biochemical or hematological factors. Studies in children were lacking. Between June 2011 and April 2014, the Italian STOP Pain project enrolled 87 paediatric cancer patients under treatment with opioids (morphine, codeine, oxycodone, fentanyl and tramadol).

Conclusions

Future studies on cancer pain should be designed with consideration for the highlighted factors to enhance our understanding of opioid non-response and safety. Studies in children are mandatory.

Trial registration

Appendix
Available only for authorised users
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Metadata
Title
A systematic review of the risk factors for clinical response to opioids for all-age patients with cancer-related pain and presentation of the paediatric STOP pain study
Authors
Ersilia Lucenteforte
Laura Vagnoli
Alessandra Pugi
Giada Crescioli
Niccolò Lombardi
Roberto Bonaiuti
Maurizio Aricò
Sabrina Giglio
Andrea Messeri
Alessandro Mugelli
Alfredo Vannacci
Valentina Maggini
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2018
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-018-4478-3

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